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Essay on sports injuries and preventative strategies
Sports injuries assignment 2 essay
Prevention and care of athletic injuries
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CHIEF COMPLAINT
Left knee pain.
SUBJECTIVE
Pittman is an 18-year-old patient who is seen at the medical clinic today in regard of follow up with his left knee pain. The patient states that in the past he had surgery for his left knee. He also seen the physical therapist in regard of left knee strain in 08/2016. Patient said that the last three days he admitted that he was playing sports with high impact and he also fell down and landed on his left kneecap. Patient noticed that he has pain in the medial aspect. The pain is local which he rated approximately like 5/10 pain level. Patient states he takes three tablets of pain medication twice daily, which resolved the pain. Patient also reports that he was fitted with ankle brace. He also have some sort of restriction and no recreational restriction for two weeks due to his pain. Patient denied any numbness or tingling, unable to weight bear. He denied any severe pain. He denied any red flag symptoms. He said that he can ambulate without assistance. He only has mild swelling over there but he stated when he fell down then he noticed that there was more swelling, but he stated compared
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to two or three days ago the swelling has subsided and the pain has also resolved with the pain medication he takes three tablets twice daily. Other than that, he has no other medical concern at this visit. He is generally healthy. He said that he is taking Zoloft and pain medication for his left knee. OBJECTIVE Vital signs were not recorded.
General: Patient is alert, oriented, not in acute distress. Not in labored breathing. Gait is non-antalgic. Cooperative and talkative mood affect. On exam of left knee inspection noticed some swelling compared with the right. Tenderness and swelling in left knee medial aspect. The scar from anterior knee is well healed. No sign of infection. Vascular exam is normal, dorsalis pedis pulses posterior, tibial pulses and capillary refill. Neurologic exam is within normal limits. Sensation and motor is intact. Motor and sensory are intact equal bilaterally. Hyperextension and flexion is within normal limits. Lachman test is negative. Knee anterior drawer test is negative. McIntosh test is negative. Inspection is no ecchymosis but there is a mild swelling in the medial
aspect. ASSESSMENT 1. Acute left knee pain. 2. History of ACL repair. 3. History of left knee strain or sprain, medial meniscus irritation. PLAN I discussed the plan of care with the patient. Patient education provided. I advised patient that he will rest, ice, compress, elevate it and modify physical activity. Also continue the NSAIDS three times daily, take it with meals and drink plenty of water. I explained to the patient to avoid football, rugby, soccer, or handball, high impact activities to the lower extremity. Will order left knee x-ray. Advised patient will follow up with the patient when the x-ray report is available. I also discussed with the patient that if he noticed any further difficulty of more swelling, or pain, red flag symptoms was discussed, and patient can return to the clinic or notify ot the medical staff sooner as needed. Patient stated he understands and he is in agreement with the plan.
Hazelwood v. Kuhlmeier of 1987-1988 Background: At Hazel East High School, the school has a sponsored newspaper called “The Spectrum” that is written and edited by the students. In May of 1983, the high school principal, Robert E. Reynolds, received the edited version of the May 13th edition. Upon inspecting the paper, he found two articles that he found “inappropriate.” The two articles contained stories about divorce and teen pregnancy. An article on divorce featured a student who blamed her father’s actions for her parents’ divorce.
Facts: Twenty one year old, University of Wyoming college student, Matthew Shepard, died October 12, 1998 at 12:53 a.m. after spending five days in a comma due to massive injuries and head trauma in a robbery and hate crime assault (Matthew Shepard, 2000 [on-line]). Matthew Shepard met Aaron McKinney (22) and Russell Henderson (21) of Laramie in a local bar called Fireside Lounge. McKinney and Henderson had been drinking. The two led Shepard to believe they were gay and lured Shepard to their truck. McKinney pulled out a gun and said, Guess what- we’re not gay and you’re gonna get jacked. McKinney then told Shepard to give him his wallet. When Shepard refused, McKinney hit him with the gun. With Henderson behind the wheel, McKinney continued to strike Shepard. McKinney then told Henderson to get a rope out of the truck. McKinney allegedly tied Shepard’s beaten body to a wooden split-rail post fence, robbed him of his wallet and patent leather shoes, continued to beat him and left him to die for over 18 hours. Chasity Vera Pasley (20) and Krista Lean Price (18), the suspect’s girlfriends, hid the bloody shoes of Henderson and provided the suspects with alibis. Shepard’s shoes, coat and credit card were found in McKinney’s pick-up truck; his wallet was found in McKinney’s home. A .357 Magnum was also found in McKinney’s home (Matthew Shepard, 2000 [on-line]).
Back with no tenderness over her kidney area. She does have a scar in her low back. Scar is surrounded by some blotchy redness, but the patient states this always looks like this. She does have pain to palpation above the scarred area and her low back. She has decreased range of motion of her low back, in general. Flexion however, causes significant pain and she is reluctant to do this. She has no pain when flexing her neck.
On admission, a complete physical assessment was performed along with a blood and metabolic panel. The assessment revealed many positive and negative findings. J.P. was positive for dyspnea and a productive cough. She also was positive for dysuria and hematuria, but negative for flank pain. After close examination of her integumentary and musculoskeletal system, the examiner discovered a shiny firm shin on the right lower extremity with +2 edema complemented by severe pain. A set of baseline vitals were also performed revealing a blood pressure of 124/80, pulse of 87 beats per minute, oxygen saturation of 99%, temperature of 97.3 degrees Fahrenheit, and respiration of 12 breaths per minute. The blood and metabolic panel exposed several abnormal labs. A red blood cell count of 3.99, white blood cell count of 22.5, hemoglobin of 10.9, hematocrit of 33.7%, sodium level of 13, potassium level of 3.1, carbon dioxide level of 10, creatinine level of 3.24, glucose level of 200, and a BUN level of 33 were the abnormal labs.
Anterior knee pain plagues the athletic community, the most common being runner’s knee or patellofemoral pain syndrome (PFPS). One point or another in an athlete’s career they have experienced this kind of pain. When comparing between male and female athletes and who has the higher chance of knee pain, female athletes have a higher prevalence than male athletes (Dolak KL). There are several different mechanisms of patellofemoral pain a few being: pes planus,an increased Q angle, weak, tight or an imbalance in the quadriceps or hip muscles. Recently in my clinic site as the spring sports such as, baseball, soccer and track and field the athlete’s perform a lot of squatting, running, and kneeling which load the patellofemoral joint. We are now starting to see several and treat several athletes with patellofemoral knee pain. Each of them experiencing the pain from a different mechanism. As an athletic trainer we want to treat not only the symptoms, but the mechanism of injury to prevent further injuries down the road. If patellofemoral pain syndrome is not properly treated it can develop into chronic diseases such as chondromalacia or arthritis, maybe eventually leading to a total knee plan. (Lee SE) Treatment while the athletes are young and symptoms aren’t severe is key to preventing further injury.
Abraham said his appointment with Dr. Yacisen has been moved to 9/12/16 by Dr. Yacisen’s office. Mr. Abraham arrived to the appointment on 9/12/16 with his Mother. He walks stiff legged to the right knee. He reports his pain in the right knee is about a 2 to 3 with twisting. Examination showed the knee to be slightly swollen but stable. Dr. Yacisen still feels he may need to have a scope done. With discussion on the length he will be working and the type of work he does Dr. Yacsien may still do an ACL repair. Mr. Abraham said he is very apprehensive about going back to work. Much discussion was given to restrictions and when he would go back. Dr. Yacisen would like physical therapy to continue and added a work conditioning also. He wants Mr. Abraham to have a custom ACL brace and must be wearing it to return to work. The brace was measured but would take about 3 weeks to come in. The left shoulder has good range of motion. Mr. Abraham said he has slight pain in the shoulder, he declined a injection. He was given a home exercise program to do by Dr. Yacisen in conjunction with formal physical therapy. Mr. Abraham said he is also driving
According to the Primary Treating Physician’s Progress Report (PR-2) dated 8/22/2017, the patient complained of a left knee pain described as constant, aching and moderate. The pain was associated with
DOI: 4/24/2013. This is a case of a 59-year-old female customer service representative who sustained injury to her left ankle when she got up after her foot “fell asleep”. As per OMNI notes, patient underwent ligament reconstruction with Brostrom repair on 1/16/2014 and left knee arthroscopy on 10/8/2014. As per office notes dated 6/21/16, the patient returns for interval followup visit. The patient has been working more and is explaining to me that she is having exacerbation of symptoms. The patient admits to increasing neuropathic pain secondary to complex regional pain syndrome. It was mention that the patient has been on Topamax and tramadol which allow the patient to get some improvement. She admits 40% improvement in the pain and she also
The patient tells me this has been ongoing now for the last two months. There was no specific injury or trauma. She was describing a pain and ache in her right leg. She said she was not paying much attention to exactly where it was and elected to go see urgent care on September 3th. I do have that note from the physician that she saw there. At that time, her main complaint was right knee pain. She had x-rays done that showed some mild osteoarthritis and she is here today to follow up on that. She says after that visit, she really started trying to pay attention to where the pain was coming from and she realized it is really coming throughout the whole leg, particularly the thigh area, the knee, down the back of the leg as well, and she also feels it a little into the right buttock. No injury or trauma. There is no real low back pain associated with this. No weakness that she has noticed. No numbness or tingling that she has had. She is having no other joint issues that she can recall. She is not having fevers. There has been no redness or swelling. She is overall feeling okay. She is a little bit more tired than typical. No associated fevers, chills, or other body
Weight 195.2 pounds, BP 118/68, pulse rate 63, temperature 97.4, respiration rate 14. The gait once again is not antalgic. He can perform a full squat without difficulty. Single leg squats reveal knee adduction bilaterally, which is mild. Palpation of the lower back shows only mild tenderness at the lower lumbar paraspinals and only at the right sciatic notch, not at the sciatic nerve trunk exit. Motor power in the lower extremities is at the 4+/5 both proximally and distally. Sensation remains diminished in the L5-S1 distribution. Reflexes were present at the knees bilaterally and absent at the right ankle, but now present at the left. Toes were downgoing. The straight leg raising maneuver was negative. The figure-of-four test revealed lower back pain
Her blood pressure earlier is 130/70. Her heart rate is irregularly irregular at about 115 beats a minute, SpO2 on two liters is 96, although her respiratory rate is 26. Temp is normal. Head, eyes, ears, nose and throat reveal no abnormalities. No temporal artery tenderness. Neck is supple. I see no JVD. I hear no carotid bruits. There is coarse rhonchi and wheezes bilaterally. I do not hear a rub. Consolidation is not well heard. Heart rhythm is irregular regular. PMI is displaced lateral on mid clavicular line. Abdomen is soft and nontender. The low ribcage impacts on the superior iliac crest bilaterally. No organomegaly is detected. There is a midline scar. There is trace ankle edema bilaterally and no calf tenderness. Peripheral pulses are reduced.
Examination revealed an oxygen saturation of 96% and chest auscultation was clear. The was no cervical lymphadenopathy or obvious hepatosplenomegaly. On the left leg there was a circular mildly??? erythematous area that was non-blanching.
Per the medical report dated 05/17/16, the patient reported bilateral hand pain with numbness and tingling for the past 7 years or so, worsening, right greater than the left side. There is some degree of numbness/tingling on the right hand at all times. She has difficulty sleeping at night due to pain and driving, doing her hair/make up or holding objects worsen her symptoms. She has tried wearing splints that they worsened the discomfort. She denies any history of steroid injections. On examination, Tinel’s, Durkan’s and Phalen’s tests are positive bilaterally. There is bilateral thenar weakness.
S: TM reports Acute Left Knee Pain. According to the TM, she was stepping into cell down the stairs and sudden pain shot though her left knee to mid tight. Reports the initial pain was sharp shooting like pain; 10/10. After Ice X 20 minutes helped to decreased her pain to 8-9/10. Now TM describes her pain as pulsation, located in her lateral and back of her knee. TM denies previous injury to the left knee. TM denies numbness, tingling, or loss of movement in her left leg.
This was his second episode since 10 days ago where he develop the same pain at his right flank. He suddenly experienced severe pain 8 hours before admission when the pain shifts to his right lower quadrant of his abdomen. The onset is at 6.30 am before worsening at 10 p.m to 2 p.m. He described the pain as continuous sharp pain and gradually increased in severity. There is no radiation of the pain. The pain was exaggerated on movement and touch. There were no relieving factor and he scale the severity as 7/10. He experienced fever for 1 day prior to admission. It was a mild grade continuous fever. He does not experienced chills and rigor. The patient does not experience any nausea or vomiting, no dysphagia, no pain during micturition and no alteration in bowel habit. He experienced loss of appetite but not notice any weight loss.